Hi. First, as far as how long between puffs, that depends on the medication and the specific directions given to you by your doctor. So you should check with them and/or with your pharmacy to answer that question.
Now, onto spacers ... it's really a personal choice. Some people find that they can get more of the medication into their lungs when they don't have to worry about timing things just right, etc. Other people feel like they do fine without them. Here's what some of our patient leaders have said about this in the past:
https://asthma.net/living/spacer-or-no-spacer
Are you newly diagnosed? Just curious if you're using a spacer right now and how you're doing generally. Thanks for reaching out! -Melissa, team member